Provider Demographics
NPI:1205395373
Name:TRAN, KATHY PHUONG (PA-C)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:PHUONG
Last Name:TRAN
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:16200 AMBER VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-4051
Mailing Address - Country:US
Mailing Address - Phone:562-620-5385
Mailing Address - Fax:
Practice Address - Street 1:16200 AMBER VALLEY DR
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-4051
Practice Address - Country:US
Practice Address - Phone:562-620-5385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant